Products and services will include, but not be limited to: a. Evaluate individuals for the need and proper fit of orthotic equipment. b. Providing, making, modifying, and repairing ankle/foot orthoses as needed. c. Providing, making, modifying, and repairing insoles and shoe inserts as needed. d. Providing, making, modifying, and repairing orthopedic footwear as needed. e. Providing, making, modifying, and repairing specialized helmets needed. f. Conduct regularly scheduled orthotic clinics at Mexia SSLC for evaluations and follow up. These are typically scheduled monthly. The contracted Orthotic Provider will provide timely documentation of evaluations, recommendations, and/or products provided. 520/70 Orthosis insoles and shoes 1 EA $ - $ - 2 L3010 Foot, insert, removable, molded to patient model, longitudinal arch support 1 EA $ - $ - 3 L3020 Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support 1 EA $ - $ - 4 L3030 Foot, insert, removable 1 EA $ - $ - 5 L3310 Lift, elevation, heel and sole, neoprene 1 EA $ - $ - 6 L3332 Lift, elevation, inside shoe, tapered, up to onehalf inch 1 EA $ - $ - 7 L3216 Orthopedic footwear, ladies shoe, depth inlay 1 EA $ - $ - 8 L3221 Orthopedic footwear, men’s shoe, depth inlay 1 EA $ - $ - 9 L3300 Lift, elevation, heel, tapered to metatarsals 1 EA $ - $ - 10 L3230 Custom shoe, orthopedic footwear, depth inlay 1 EA $ - $ - 11 L2360 Addition to lower extremity, extended steel shank 1 EA $ - $ - 12 L5000 Partial foot, shoe insert with longitudinal arch, toe filler 1 EA $ - $ - 13 L3580 Orthopedic shoe addition, convert instep to velcro closure 1 EA $ - $ - 14 L1930 Ankle foot orthosis, plastic or other material 1 EA $ - $ - 15 L1940 Ankle foot orthosis, plastic or other material 1 EA $ - $
